Improving the DnD Constitution attribute

The Constitution attribute is mightily under-used; it's the only attribute without related skills! Can we make it better?

Posted: January 3, 2023Updated: January 14, 2023
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In Dungeons and Dragons, the Constitution attribute is the only attribute that has no related skills. There is only a saving throw, usually used for resisting poison or drunkenness. This means that characters end up dedicating valuable points to an attribute that is rarely used. What are some ways to make Constitution more than just a measure of a character's health points? How can we give players more opportunities to use Constitution in meaningful ways during gameplay?

New skills

The most obvious option that comes to mind is creating new skills that depend on Constitution. Adding more skills to Constitution can open the game up to richer, more nuanced play and story-telling. This can allow the players to think more deeply about how some of these attributes can be used.

Let's take a look at some new potential Constitution skills.


Anytime a player character needs to perform some physical feat, they almost always roll a Strength check. However, longer-lasting activities that rely more on stamina than brute strength are a great candidate for a Constitution check. Take, for example, the following activities:

  • long-distance running
  • long-distance swimming
  • holding breath
  • maintaining strength without food and drink
  • resistance to exhaustion (e.g., doctors working long shifts or soldiers executing long operations without sleep)

If a character has gone an extended period without a long rest, you could have them roll an Endurance check to see if they resist gaining a level of exhaustion a while longer.

The Endurance skill could also come into play for chases (see DMG, p. 242). Instead of rolling Constitution saving throws, players can roll Endurance checks to determine whether they can dash again without taking exhaustion levels.

Iron Gut

This one might not have as many obvious uses, but it fits cleanly into Constitution. This could apply to activities like:

  • competition eating or drinking
  • surviving with limited rations
  • eating dangerous food

A character with proficiency in Iron Gut could consume less palatable food or drink without becoming sick. This would be useful in survival situations in the wilderness.


Constitution is essential to establishing a character's overall health. Shouldn't it also affect how quickly they can recover from injuries or exhaustion?

A potential idea would be to alter the healing mechanic to make healing be more or less effective based on a Recovery skill roll. When a character attempts to regain health (via potion, healing spell, hit dice, &c.), they roll for Recovery. A roll of 7 or below heals for half the amount, 8-16 heals regularly, and 17 or above offers twice the amount of health.

Players could also keep track of more granular details of injuries that their characters sustain and the time it takes those to heal. If a character badly injures their arm in a fall, they may need to roll Recovery checks each morning until they are able to perform regular activities again.


With higher Constitution, a character might be able to withstand the effects of extreme environments. In the Dungeon Master's Guide (DMG p.110), some extreme weather conditions are mentioned, such as Extreme Heat, Extreme Cold, and Frigid Water. These conditions cause players to roll Constitution saving throws to avoid ill effects such as exhaustion.

Instead of rolling Constitution saving throws, the players could roll a Hardiness check to resist the heat or cold. This could even be applied to combat, allowing the player to shrug off some fire or ice damage from a spell.


A skill like Resilience could help the character resist physical damage. If a character suffers fall damage, a Resilience roll could determine if that fall damage is lessened or increased from the baseline.

It could even be used in combat. A player could roll a Resilience check to attempt to shrug off the effects of a critical hit; if they beat a DC 20, then they just take regular damage instead.

Be careful with this one! Getting a critical hit feel awesome as a player, but having that immediately disregarded because an NPC rolls a good Resilience check could be disheartening. Don't make the game miserable, and be careful about combat balance.

Isn't this just complicating things?

"Wait!" You might exclaim. "Most of the situations that could come up in-game can just be handled with a saving throw!" If we follow that thread, though, we could just start reducing all other skill checks to saving throws as well.

  • Instead of telling your player to "make a Sleight of Hand check to pickpocket the guard", you could reduce this to "make a DEX save to see if you can pull your hand back with the key before he notices you."
  • Instead of saying "make an Athletics check to see if you can climb this wall", you could reduce it to "make a STR saving throw to see if you can climb the wall before your strength gives out."

I'd also argue that there's a reason we have proficiencies and expertises in the other attributes. Let's take Charisma for example: a Bard might have very good Charisma with expertise in Performance. Having a high Charisma attribute means he will inherently be better than average at all CHA checks, but being good at Performance doesn't automatically make someone good at Intimidation.

The same logic should apply to Constitution. Someone with good CON would probably be better on average at holding their breath than someone with low CON, but that doesn't mean they're equally good at holding their breath as they are at long-distance running or toughing out extremely cold weather. Introducing new skills can make Constitution a richer element to explore in games.

Give it a shot!

In the end, the Constitution attribute in Dungeons and Dragons has the potential to be much more than just a measure of a character's health points. By introducing new skills like Endurance, Iron Gut, Recovery, Hardiness, and Resilience, players can make use of Constitution in a variety of situations and add depth to their characters. These skills not only add new gameplay elements, but also allow players to role-play their characters in more interesting and realistic ways. Whether you're a seasoned D&D player looking to add new dimensions to your game or a beginner seeking to fully utilize your character's attributes, these new Constitution skills are worth considering. Give them a try in your next game and see how they enhance your play experience!